Sutureless, bloodless, safe new circumcision technique

Wael Barakaat Ahmed Mohamed, Ahmed Eisa Ahmed


Background: Several techniques of circumcision are available such as conventional surgical technique, the device (Gomco, Plastibell), mono and bipolar diathermy and sutureless methods such as fibrin glue. Our knowledge, the first report of using harmonic scalpel in circumcision was published by Peng et al, in the Asian journal of andrology but the study was done on dogs, this one of the little studies describe the use of the harmonic scalpel in male circumcision in humans. Aim was to describe the technique of the harmonic scalpel circumcision and report its outcomes in the term of safety and efficacy.

Methods: This was a prospective observational study performed in the general surgery department at Sohag university hospital, Sohag, Egypt from 1st January 2015 to 31 December 2016.

Results: 90 male patients were included in this study. Their age ranged between 3 and 18 years. The most common indication was religious circumcision 50%. No intraoperative blood loss or a postoperative bleeding. One case of wound infection and three cases of a postoperative edema respond to conservative treatment. No injury to the surrounding structure.

Conclusions: The result of this study determines that the harmonic scalpel circumcision not associated with intraoperative blood loss or postoperative bleeding and a good postoperative cosmetic result, with a minimal complication. So, it is an appropriate alternative to the traditional scalp and suture technique.


Circumcision, Harmonic, Male, Penis, Phimosis, Sutureless

Full Text:



Mokal N, Chavan N. Modified safe technique for circumcision. Indian J Plast Surg. 2008;41:47-50.

Rizvi S, Nagvi S, Hussain M, Hasan A. Religious circumcision: a Muslim view. Br J Urol Int. 1999;83:13-6.

Williams N, Kapila L. Complications of circumcisions. Br J Surg. 1993;80:1231-4.

American academy of Pediatrics. Male circumcision. Pediatrics. 2012;130:756-85.

Morris BJ, Mindel A, Tobian AA, Hankins CA, Gray RH, Bailey RC, et al. Should male circumcision be advocated for genital cancer prevention? Asian Pac J Cancer Prev. 2012;13(9):4839-42.

Morris BJ, Gray RH, Castellsague X, Bosch FX, Halperin DT, Waskett JH, et al. The strong protective effect of circumcision against cancer of the penis. Adv Urol. 2011;2011:812368.

Gerharz EW, Haarmann C. The first cut is the deepest? medicolegal aspects of male circumcision. BJU Int. 2000;86:332-8.

Tucker SC, Cerqueiro J, Sterne GD, Bracka A. Circumcision: a refined technique and 5-years review. Ann R Coll Surg Engl. 2001;83:121-5.

Peng M, Meng Z, Yang ZH, Wang XH. The ultrasonic harmonic scalpel for circumcision: experimental evaluation using dogs. Asian J Androl. 2013;15;93-6.

Schosen EJ. The status of circumcision in newborn. New E J Med.1990;322;1308-1322.

Arunachalam P, King PA, Orford J. A prospective comparison of tissue glue versus sutures for circumcision. Pediatr Surg Int. 2003;19:18-9.

Subramaniam R, Jacobsen AS. Sutureless circumcision: a prospective randomized controlled study. Pediatr Surg Int. 2004;20:783-5.

Kaplan GW. Complications of circumcision. Urol Clin North Am. 1983;10:543-6.

Lane V, Vajda P, Subramaniam R. Pediatric sutureless circumcision: a systematic literature review. Pediatr Surg Int. 2010;26:141.

Kelly BD, Lundon DJ, Timlin ME, Sheikh M, Nusrat NB, D’Arcy FT, et al. Paediatric sutureless circumcision: an alternative to the standard technique. Pediatr Surg Int. 2012;28:305-8.

Ozkan KU, Gonen M. Wound approximation with tissue glue in circumcision. Int J Urol. 2005;12:374-7.

Fraser ID, Goede AC. Sutureless circumcision. BJU Int. 2002;90:467-8.